Seanad debates

Wednesday, 17 November 2010

National Paediatric Hospital: Statements

 

11:00 am

Photo of Mary HarneyMary Harney (Dublin Mid West, Independent)

I am pleased to be here to speak about the national paediatric hospital.

The national paediatric hospital is a major priority project for the Government and notwithstanding the financial pressures the country is under, the capital funding for the project is protected in the four-year plan which will be submitted to the European Union in the next ten days or so. The reason it is protected is because the status quo as far as sick children are concerned is not an option.

In 2004, when I became Minister for Health and Children, the plan was to build a new hospital for Temple Street at the Mater hospital site and also to build a new hospital for Crumlin. Between them, they were to have approximately 700 beds and cost somewhere in the region of €600 million to €800 million. The view was taken by many paediatricians in the country that instead of building two new hospitals and also keeping Tallaght hospital, we should look at the prospect of bringing all of the children's hospitals in Dublin together to create a world-class tertiary children's hospital for the sick children of Ireland.

McKinsey was appointed to carry out a review of paediatric services in Ireland and to examine global experiences in this regard. It looked at 17 children's hospitals around the world and all of those hospitals were co-located with adult hospitals. McKinsey recommended, given the relatively small number of sick children in Ireland and given the requirement when it comes to complex care and sub-specialisation, which is a strong feature of medicine, that many of the clinicians that would work with very sick children would also have to work with adults and the new children's hospital should be co-located with an adult teaching hospital. In addition to the benefits from a clinical point of view in dealing with complex cases and sub-specialisation, there are significant synergies that come from a research perspective and, obviously, there are considerable savings from bringing all of those hospitals together. We estimate the bringing together of the three hospitals from a back-office point of view will save in the region of €25 million to €30 million a year alone in operating costs.

The Government endorsed the McKinsey report on the recommendation of the HSE and then a group was put together chaired by the OPW - the late Mr. David Byers, a highly respected architect in OPW. There were 12 persons on that group, including representatives of different Departments, those with architectural expertise and site expertise, to receive applications on where that hospital might be located.

When the McKinsey report recommended co-location with an adult hospital, the three hospitals in Dublin - Crumlin, Tallaght and Temple Street - all endorsed that very enthusiastically. I remember having many meetings with different paediatricians in the city and they felt this was the appropriate future for sick children. When, however, we came to deciding on the site it was a different matter.

A number of sites were advanced. Tallaght was advanced, St. Vincent's was advanced as a possibility, Blanchardstown made a case, and so did Beaumont, the Mater and St. James's hospitals. It came down to two sites, either St. James's hospital or the Mater hospital.

The St. James's hospital site had a number of difficulties with it. It was a site that had restrictions and there were issues around the preservation of buildings on that site. The Mater hospital site was an unencumbered site and, therefore, it was felt that it was appropriate.

In any event, some of these sub-specialists who will work with sick children will still be attached to Beaumont and they will travel to the Mater hospital site to treat sick children, and some of this expertise will be in St. James's hospital and they will travel to the Mater hospital site as well. At present, what happens is the children travel to the doctors from the different hospitals. When the new hospital is built, most of the expertise will be located within the hospital but some of the expertise, because it will work with adults, will be located in other hospitals that have national tertiary facilities in the city.

At that point a major controversy arose. This controversy is not unique to Ireland. Last week there was an event in Farmleigh for the Crumlin Foundation where a doctor from Manchester spoke. He stated that for 40 years there was much bickering among the three hospitals in Manchester. It took them nine years to decide where to locate the new hospital, but they are now together in one hospital and it has been a breathe of fresh air. He spoke as somebody who was sceptical of bringing the three hospitals together.

After the site was selected and the development board was put in place, RKW, a world expert on hospital planning, came to advise on the requirements of the hospital. It also looked at 17 different hospitals around the world. In fairness, many of the hospitals were similar to the ones at which McKinsey looked. Between the two, 25 different hospitals were examined. Twenty-four of the 25 hospitals are co-located with adult hospitals. Right around the world that is seen as the future for paediatric care, that one brings not only the children and the adults together, but also maternity, so that high-risk pregnancies can be dealt with in the site that deals with very sick children and where mothers can be dealt with as well in an adult facility. The new hospital will cost approximately €650 million. Of this, €450 million will be made available by the taxpayers. At present, €400 million is in the capital plan and there will be an extra €50 million in the capital plan next year. To date, €25 million has been spent on the planning phase and on the various expertise that has inputted into the requirements of the hospital. There is a shortfall of up to €200 million. Of that, €90 million will come from commercial sources such as car parking, retail space in the hospital and consultant rooms and €110 million will come from philanthropy. I know many people are sceptical about €110 million being raised from philanthropy over the next four years. In Canada the year before last, $98 million was raised through philanthropy for a children's hospital. Throughout the world, children's hospitals are the easiest to raise money for, but I am not stating that it will not be a challenge.

The new chairman of the board, John Gallagher, has a fantastic track record in philanthropy. He has much expertise and experience and at present the board is putting together the foundation that will raise this philanthropy. The hospital has received charitable status from the Revenue Commissioners. Recently, I visited New Zealand and saw the Starship Children's Hospital which raised a considerable amount of its funding from philanthropy. Tied to the philanthropy will be the research input. Pharmaceutical companies, medical device companies and companies which supply inputs to children's hospitals are always keen to provide philanthropy where it is tied in with research. A very central part of this new children's hospital will be the research dimension and we should not underestimate its significance.

All of the rooms in the hospital will be single rooms. These rooms will have parent accommodation and it will be the most modern hospital that this country can provide and afford. It will provide an environment not only for sick children but also for those who work with sick children that will be among the best in the world. I have had an opportunity to visit a number of children's hospitals in recent years. In Chicago, the children's hospital is being moved from the equivalent of Ballsbridge in Dublin to the equivalent of Grafton Street, just off Michigan Avenue. The reason it is being moved to the centre of the city is to be co-located with an adult hospital for all the reasons, synergies and benefits that have been recommended here.

When the parents of sick children came to see me in 2004 they stated they did not care where the new hospital would be, they just wanted me to make it happen. When McKinsey reported, the parent's group from Crumlin hospital commissioned Dr. Pollock, a very well-renowned paediatrician and well-known in Ireland because he has advised us on our cystic fibrosis strategy, to advise it on whether the new hospital would provide the environment necessary for sick children. The parents asked him one question, which was whether the new hospital on the proposed site could provide the international standards of excellence in tertiary health care for their children. His response was that it most certainly could. The synergy created by assembling some of the best clinical and research skills in the country on a single site would create the environment for Ireland to progress further in international standing with measurable benefits for children and adults. To this day, the parents of sick children at Crumlin hospital remain totally enthusiastic for this project.

It is the case that there has been controversy about the site and some people advance every single argument as to why it should not happen. I sometimes feel that if they wake up and hear a negative, it is music to their ears. I would understand the controversy if the Government was withdrawing funding and naturally it would be right that there should be controversy. I do not understand the controversy surrounding the site. I accept that there are access issues and they have to be rectified by Dublin City Council. As the Bristol inquiry stated, however, the issue of access must be secondary to the quality of clinical care for children. That was the outcome. There is no site in the country-----

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